rogression of coronary atherosclerosis and rupture of unstable plaque are key processes in acute myocardial infarction (AMI). The extent of coronary artery disease has been well documented as a major prognostic factor in patients with AMI. Prevention and evaluation of the progression of atherosclerotic plaque volume is thus essential to both reduce cardiac events and estimate prognosis after AMI.Evidence that supplementation with n-3 polyunsaturated fatty acids prevents atherosclerosis-related cardiovascular risk has been accumulating. 1,2 More recently, a large randomized study demonstrated that eicosapentaenoic acid (EPA) is effective in preventing major coronary events in patients with hyperlipidemia. 3 Dysfunction of the vascular endothelium, fatty streak formation and fibrous cap formation are processes in the formation of atherosclerotic lesions that are regulated by the action of vasoactive molecules, growth factors, cytokines, and lipid metabolites. Several studies have demonstrated that supplementation with n-3 polyunsaturated fatty acids attenuates the exaggerated platelet aggregation induced by various stimuli, 4,5 attenuates the action of growth factors and cytokines, 5-7 reduces the serum triglyceride concentration, 8,9 and increases high-density lipoprotein levels. 8 There are several methods of evaluating coronary atherosclerotic lesions. Coronary angiography is widely used as the gold-standard to determine coronary stenosis, but it can only detect a luminal reduction in stenosis, collateral patterns and the presence of dense calcification of the coronary arteries, not plaque quantity. Coronary angioscopy and intravascular ultrasound (IVUS) can provide information about plaque characteristics to some extent, 10-14 but the observation areas are somewhat restricted and the methods are quite invasive. Multidetector spiral computed tomography (MDCT) with high slice numbers is now providing sufficient time and spatial resolution power to detect coronary atherosclerosis. 15,16 Its reliability in the determination of coronary plaque morphology has been recently demonstrated by studies using IVUS and histopathologic studies. 17,18 The advantages of MDCT are that it is relatively noninvasive compared with intracoronary angioscopy and IVUS, and has sufficient stability for observation of the entire coronary tree. Indeed, at present, MDCT is thought to be 1 of the best methods of evaluating coronary plaque characteristics.Based on these lines of evidence, we hypothesized that serum n-3 polyunsaturated fatty acid levels would correlate with the extent of coronary atherosclerotic lesions. The Background The relationship between serum fatty acid levels and the extent of coronary plaques and calcification was examined in patients with acute myocardial infarction (AMI). Methods and ResultsThe serum levels of the n-3 polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) and the n-6 polyunsaturated fatty acids (arachidonic acid (AA) and dihomogamma-linolenic acid (DGLA)) were det...
We studied the association of serum levels of arachidonic acid (AA) and eicosapentaenoic acid (EPA) with the prevalence of major adverse cardiac events (MACE) after acute myocardial infarction (AMI). We measured serum AA and EPA on admission in 146 consecutive AMI patients. The primary clinical endpoint was occurrence of MACE, defined as cardiac death, occurrence of heart failure, reinfarction, recurrent angina pectoris, and requirement of coronary intervention. Common logarithmic transformed serum levels of AA (logAA) and EPA (logEPA) were used in the analyses. The optimum cutoff point of each fatty acid used to distribute patients into two groups for Kaplan-Meier analysis was determined by receiver operating characteristic curves analysis. MACE occurred in 40 patients (27.4%). Kaplan-Meier analysis disclosed that the group with a logAA above the cutoff point [145.3 μg/mL (logAA 2.162)] showed a higher prevalence of MACE than those with a logAA below the cutoff point (P < 0.01). Conversely, the prevalence of MACE was significantly higher in the group with a logEPA below the cutoff point [52.3 μg/mL (logEPA 1.719)] compared to the group with a logEPA above it (P < 0.01). Similar to logAA, logAA/logEPA showed significant differences in the MACE-free curve between the two groups (cutoff 1.301, P < 0.001). Cox proportional hazards regression analysis suggested that logAA, logEPA, and logAA/logEPA were independently associated with the prevalence of MACE. Although the present study included a limited number of patients with single-time point measurement, the results suggested an association of logAA, logEPA, and logAA/logEPA with the prevalence of MACE after AMI. The present study warrants further studies involving a large number of patients to confirm that the serum levels of these fatty acids and their ratios are predictors of MACE after AMI.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.